What is the Association with Several Physical, Mental, & Cognitive Health Outcomes with Gait Speed in Older Adults?

Research Paper Title

Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes.

Background

Although clinical gait speed may indicate health and wellbeing in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes.

The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44 meter walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults.

A cross-sectional design was used.

Methods

The study population comprised 432 high-functioning community-dwelling older adults (287 women) aged between 65 and 92.

Clinical and ambulatory gait speeds were measured using the 2.44 m walk test and a portable gait analysis device, respectively.

Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (BMI, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper and lower body strength, physical and mental health status, cognitive status and self-rated cognitive status).

Results

The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared.

Clinical gait speed was associated with 7 health outcomes, while the ambulatory gait speed was associated with 6 health outcomes.

The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied, however, the strength of associations were singly different between measures.

The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study.

Conclusions

The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed.

Both measures have construct validity because they have been associated with physical and health outcomes, however, they may have different predictive validity.

Further research should be done to compare their predictive validity in longitudinal designs.

Reference

De la Cámara, M.Á., Higueras-Fresnillo, S., Sadarangani, K.P., Esteban-Cornejo, I., Martinez-Gomez, D. & Veiga, Ó.L. (2020) Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes. Physical Therapy. pii: pzz186. doi: 10.1093/ptj/pzz186. [Epub ahead of print].

Cognitive Subgroups of Schizophrenia: Are There Brain Morphological & Functional Features?

Research Paper Title

Brain morphological and functional features in cognitive subgroups of schizophrenia.

Background

Previous studies have reported different brain morphologies in different cognitive subgroups of patients with schizophrenia. The researchers aimed to examine the brain structures and functional connectivity in these cognitive subgroups of schizophrenia.

Methods

The researchers compared brain structures among healthy controls and cognitively deteriorated and preserved subgroups of patients with schizophrenia according to the decline in intelligence quotient.

Connectivity analyses between subcortical regions and other brain areas were performed using resting-state functional magnetic resonance imaging among the groups.

Results

Whole brain and total cortical gray matter, right fusiform gyrus, left pars orbitalis gyrus, right pars triangularis, left superior temporal gyrus and left insula volumes and bilateral cortical thickness were decreased in the deteriorated group compared to the control and preserved groups.

Both schizophrenia subgroups had increased left lateral ventricle, right putamen and left pallidum and decreased bilateral hippocampus, left precentral gyrus, right rostral middle frontal gyrus and bilateral superior frontal gyrus volumes compared with controls.

Hyperconnectivity between the thalamus and a broad range of brain regions was observed in the deteriorated group compared to connectivity in the control group, and this hyperconnectivity was less evident in the preserved group.

The researchers also found hyperconnectivity between the accumbens and the superior and middle frontal gyri in the preserved group compared with connectivity in the deteriorated group.

Conclusions

These findings provide evidence of prominent structural and functional brain abnormalities in deteriorated patients with schizophrenia, suggesting that cognitive subgroups in schizophrenia might be useful biotypes to elucidate brain pathophysiology for new diagnostic and treatment strategies.

Reference

Yasuda, Y., Okada, N., Nemoto, K., Fukunaga, M., Yamamori, H., Ohi, K., Koshiyama, D., Kudo, N., Shiino, T., Morita, S., Morita, K., Azechi, H., Fujimoto, M., Miura, K., Watanabe, Y., Kasai, K. & Hashimoto, R. (2019) Brain morphological and functional features in cognitive subgroups of schizophrenia. Psychiatry and Clinical Neurosciences. doi: 10.1111/pcn.12963. [Epub ahead of print].